New-onset alcohol use disorder spiked in first 3 months of COVID-19 pandemic
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Patients diagnosed with COVID-19 during the first 3 months of the pandemic had a twofold higher risk for developing alcohol use disorder, likely driven by anxiety and fear surrounding the pandemic, according to new research.
“Alcohol use disorder (AUD) affects both the individual and society,” Veronica R. Olaker, BS, of the Center for Artificial Intelligence in Drug Discovery at Case Western Reserve University School of Medicine, and colleagues wrote in JAMA Network Open. “The patient is at risk for disorders of the liver, pancreas, brain, gut, cardiovascular system, immune system and musculoskeletal system. In 2019, the CDC estimated the annual cost of AUD at $249 billion, including lost workplace productivity, medical care, accidents and criminal justice system costs. For all these reasons, reports of increased AUD diagnoses during the COVID-19 pandemic are particularly concerning.”
They added, “As the pandemic social context and SARS-CoV-2 variants evolve, it remains unclear how the risk of a new diagnosis of AUD after SARS-CoV-2 infection varies with time during the pandemic.”
In a retrospective cohort study, Olaker and colleagues compared new AUD diagnoses from January 2020 through January 2022 among 1,201,082 patients with COVID-19 (mean age, 46.2 years; 56.9% women; 65.7% white) and 1,620,100 patients with other respiratory infections and no prior COVID-19 infection (mean age, 44.5 years; 60.4% women, 71.1% white). Researchers stratified results by 3-month intervals based on the time of index infection.
Results demonstrated a “significantly increased risk” for a new AUD diagnosis in 2020 among those who contracted COVID-19 from January to March compared with the control group (HR = 2.53; 95% CI, 1.82-3.51). The risk decreased from April to July (HR = 1.01; 95% CI, 0.79-1.28), August to October (HR = 1.07; 95% CI, 0.85-1.34) and November to January 2021 (HR = 0.96; 95% CI, 0.8-1.15).
In 2021, the risk for AUD diagnosis after COVID-19 infection increased again from January to April (HR = 1.3; 95% CI, 1.08-1.56) and April to July (HR = 1.8; 95% CI, 1.47-2.21), with a subsequent decrease in risk from July to October (HR = 1.17; 95% CI, 0.98-1.4) and November to January 2022 (HR = 1.14; 95% CI, 0.97-1.33).
Researchers also noted a “similar temporal pattern” in new diagnoses of AUD 3 to 6 months following infection with COVID-19 vs. other index events, such as other respiratory infections or fracture.
“Elevated risk for AUD after COVID-19 infection compared with non-COVID-19 respiratory infections during some time frames may suggest an association of SARS-CoV-2 infection with the pandemic-associated increase in AUD,” Olaker and colleagues wrote. “However, the lack of excess hazard in most time blocks makes it likely that the circumstances surrounding the pandemic and the fear and anxiety they created also were important factors associated with new diagnoses of AUD.”
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